Patient-Clinician Communication About End-of-Life Care in Patients With Advanced Chronic Organ Failure During One Year

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Abstract

CONTEXT: Patient-clinician communication is an important prerequisite to delivering high-quality end-of-life care. However, discussions about end-of-life care are uncommon in patients with advanced chronic organ failure. OBJECTIVES: To examine the quality of end-of-life care communication during one-year follow-up of patients with advanced chronic organ failure. In addition, we aimed to explore whether and to what extent quality of communication about end-of-life care changes towards the end of life and whether end-of-life care communication is related to patient-perceived quality of medical care. METHODS: Clinically stable outpatients (n=265) with advanced chronic obstructive pulmonary disease, chronic heart failure, or chronic renal failure were visited at home at baseline and four, eight, and 12 months after baseline to assess quality of end-of-life care communication (Quality of Communication Questionnaire, QOC). Two years after baseline, survival status was assessed and if patients died during the study period, a bereavement interview was done with the closest relative. RESULTS: One-year follow-up was completed by 77.7% of the patients. Quality of end-of-life care communication was rated low at baseline and did not change over one year. Quality of end-of-life care communication was comparable for patients who completed two-year follow-up and patients who died during the study. The correlation between quality of end-of-life care communication and satisfaction with medical treatment was weak. CONCLUSION: End-of-life care communication is poor in patients with chronic organ failure and does not change towards the end of life. Future studies should develop an intervention aiming at initiating high-quality end-of-life care communication between patients with advanced chronic organ failure and their clinicians.
Original languageEnglish
Pages (from-to)1109-1115
Number of pages7
JournalJournal of Pain and Symptom Management
Volume49
Issue number6
DOIs
Publication statusPublished - Jun 2015

Keywords

  • End-of-life care
  • palliative care
  • communication
  • chronic obstructive pulmonary disease
  • chronic heart failure
  • chronic renal failure
  • OBSTRUCTIVE PULMONARY-DISEASE
  • CHRONIC HEART-FAILURE
  • PALLIATIVE CARE
  • HEALTH-CARE
  • RANDOMIZED-TRIAL
  • SEVERE COPD
  • QUALITY
  • SKILLS
  • PRACTITIONERS
  • INTERVENTION

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